Role of Sperm Morphology in Deciding Between Various Assisted Reproduction Technologies

Sperm morphology has long been used as a clinical tool in the assessment of men with infertility. In the past, high percentages of abnormal sperm have been associated with lower pregnancy rates. However, significant intra- and interlaboratory variation has been found for sperm morphology assessment and several recent meta-analyses have demonstrated that sperm morphology is no longer predictive of lower pregnancy rates when using assisted reproduction technology (ART). As the validity of the test and the predictive nature of sperm morphology are no longer as robust as before, clinicians should not rely on percentage thresholds for normal sperm when deciding on which ART to opt for. Instead, clinicians should base ART decisions on other reproductive factors.